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This study aimed to examine dietary nutrient intake and parental perspectives on nutrition in a diverse sample (e.g., age, ethnicity) of children with autism spectrum disorder (ASD) in the U.S. state of Florida. Forty-one parents of children with ASD (ages 2-17 years) completed a food record, and 25 of these parents participated in semi-structured focus groups. Children with ASD were significantly less likely to meet the recommendation for calcium compared with children in the general population (66.7% vs. 53.1%, odds ratio [OR] = 3.1; p = 0.002). Riboflavin and vitamin B12 intakes were significantly lower among children with ASD (p < 0.001). Focus group results indicated parental concerns on children's diet and mealtime behaviors. Parents discussed the quality of existing nutrition information to be a concern, reported wanting intervention content on effective feeding strategies and healthy eating specific to children with ASD, and wanted to receive a nutrition intervention in multiple delivery formats. These findings will be utilized in developing a nutrition education intervention.

Adolescents with autism spectrum disorder are at increased risk of unhealthy eating behaviors and obesity. This study examined feasibility of a virtual implementation of Bringing Adolescent Learners with Autism Nutrition and Culinary Education, an 8-week nutrition intervention based on social cognitive theory that addresses autism spectrum disorder--specific eating behaviors and food environment challenges. The implementation process was measured with fidelity checklists, engagement records, and field notes. Feasibility of virtually assessing adolescents' outcomes (food frequency questionnaire, psychosocial survey, height, and weight) was also evaluated. Adolescents with autism spectrum disorder aged 12-21 years were recruited through a local community partner. Six groups (n = 27; group size ranged 2-7) participated. Univariate data analyses were performed. Mean lesson attendance was 88%, participation was 3.5/4 (4 = Frequently), homework completion was 51.9%, fidelity was 98.9%, and technical difficulty prevalence was 0.4/2 (2 = Major technical difficulties). Assessment completion rate was 100% (98.9%-100%) at baseline and 92.6%-96.3% (99.5%-100%) at post-intervention. Data quality was high for 88% of food frequency questionnaires and 100% of psychosocial surveys. Findings suggest that a virtual implementation and evaluation of Bringing Adolescent Learners with Autism Nutrition and Culinary Education was feasible. Bringing Adolescent Learners with Autism Nutrition and Culinary Education may be implemented virtually to reach diverse populations of adolescents with autism spectrum disorder. Future research should examine the impact of the intervention on dietary behavior and obesity outcomes.

Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating behaviors, parental feeding practices, and children's eating behaviors. A cross-sectional study was conducted with 76 parents of children from an elementary school in Tampa, FL. Parents completed three questionnaires with topics related to parent eating behaviors, parental feeding practices, and children's eating behaviors. Multiple regression analysis was performed, controlling for demographic covariates. Parents who reported to eat more fruits per day ([beta] = 0.15), eat more than one kind of fruit each day ([beta] = 0.33), eat more than one kind of vegetable each day ([beta] = 0.29), eat 2 or more vegetables at the main meal ([beta] = 0.36), plan meals ([beta] = 0.19), and keep vegetables ready for the child to eat ([beta] = 0.25) indicated that they use more positive reinforcement feeding practices (all p [less than or equal to] 0.001). There were significantly positive associations between positive reinforcement and children's eating fruits or vegetables like apples, bananas or carrots as snacks ([beta] = 1.03) and eating more than one kind of vegetable a day ([beta] = 1.03; all p < 0.001). No other variables had any significant associations. Findings of this study indicate that there are potential associations among parent's own eating behaviors, feeding practices, and children's eating behaviors. Further research is needed to determine the mechanism of these relationships. Targeting these parental factors may be an effective way to maximize the impact of nutrition interventions on children's dietary behavior changes., Author(s): Heewon L. Gray [sup.1] , Acadia W. Buro [sup.2] , Sweta Sinha [sup.3] Author Affiliations: (1) grid.170693.a, 0000 0001 2353 285X, College of Public Health, University of South Florida, [...]

Youth with autism spectrum disorder (ASD) demonstrate unhealthy eating behaviors and dietary patterns compared to their neurotypical counterparts. Given the increased risk of unhealthy weight gain and the onset of the COVID-19 pandemic, modified nutrition programs in this population are warranted. The authors independently conducted two virtual pilot interventions during COVID-19 that offered feasible and acceptable alternatives to in-person delivery, providing unique opportunities for participant engagement and family involvement. Future virtual nutrition education programs for adolescents with ASD may include visual and verbal aids through Zoom, more parent/family integration, and accommodations for those with varying ASD severity levels. [ABSTRACT FROM AUTHOR]

Background: Schools are frequent settings for childhood obesity prevention; however, intervention results are mixed. Classroom context may hold important clues to improving these interventions. Methods: We used mixed methods to examine classroom context during a curriculum intervention taught by trained instructors in fifth grade classrooms. We identified classrooms with high and low buy-in using cluster analysis and compared intervention delivery and reception, student energy balance-related behavior, and student perceptions about supports and barriers to energy balance. Results: Delivery and reception did not differ between the groups. Between-group differences in unhealthy behaviors were smaller at posttest, due to improvement in low buy-in classes. Although student perceptions of supports and barriers to energy balance were similar across groups, students in high buy-in classes indicated food preferences as a support while students in low buy-in classes indicated food preferences as a barrier. Neighborhood environment emerged as a universal barrier. Conclusions: Trained instructors may improve intervention delivery and reception regardless of classroom context. Social norms could explain high levels of unhealthy behavior in low buy-in classes at baseline; improvement at posttest suggests that the curriculum may have motivated change. All children need more strategies and supportive policies to overcome a challenging food environment.

This study aimed to examine dietary nutrient intake and parental perspectives on nutrition in a diverse sample (e.g., age, ethnicity) of children with autism spectrum disorder (ASD) in the U.S. state of Florida. Forty-one parents of children with ASD (ages 2–17 years) completed a food record, and 25 of these parents participated in semi-structured focus groups. Children with ASD were significantly less likely to meet the recommendation for calcium compared with children in the general population (66.7% vs. 53.1%, odds ratio [OR] = 3.1; p =.002). Riboflavin and vitamin B12 intakes were significantly lower among children with ASD (p <.001). Focus group results indicated parental concerns on children's diet and mealtime behaviors. Parents discussed the quality of existing nutrition information to be a concern, reported wanting intervention content on effective feeding strategies and healthy eating specific to children with ASD, and wanted to receive a nutrition intervention in multiple delivery formats. These findings will be utilized in developing a nutrition education intervention. [ABSTRACT FROM AUTHOR]

Background: New federal health guidance was issued for early childhood education (ECE) programs to reduce the risk of COVID-19 in March 2020. The Centers for Disease Control and Prevention recommended mask-wearing for adults and children aged 2 years and older. Wearing masks was a new practice for teachers and children, and this study investigated when and how masks were worn in ECE centers in Florida. Methods: This study was part of a larger assessment of the impact of COVID-19 on mealtime routines in ECE centers. Two statewide surveys based on the Trust Model were sent to directors and teachers via Florida Department of Children and Families. Only teachers were interviewed. Data were collected from August to October 2020. The analysis included survey results and interview responses related to mask-wearing. Results: Surveys were completed by 759 directors and 431 teachers, and 29 teachers were interviewed. Survey results indicated that more teachers than children wore masks during pre- and postmeal activities. Interviews revealed three models that explain mask-wearing: (1) teachers only, in which teachers were required to wear a mask, but children were not; (2) teachers and children, in which teachers and children were required to wear a mask; and (3) masks optional, in which teachers and children could choose to wear a mask. Conclusion: Understanding how decisions about mask-wearing were made at the center level can inform training and support health and safety in ECE. Use of personal protective equipment (such as masks) is effective for reducing risk of pathogen transmission for children and adults in ECE settings. [ABSTRACT FROM AUTHOR]

Background Childhood obesity is a major public health concern and families play an important role. Improving strategies to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change., Author(s): Hiershenee B. Luesse [sup.1] , Rachel Paul [sup.2] , Heewon L. Gray [sup.3] , Pamela Koch [sup.2] , Isobel Contento [sup.2] , Victoria Marsick [sup.4] Author Affiliations: (Aff1) Research, [...]

Although the COVID-19 pandemic has increased the importance of digital technology in clinical trial implementation, there is a dearth of literature reporting on challenges and strategies related to multi-site randomized controlled trials (RCTs) among pediatric cancer survivors during the pandemic. This paper discusses challenges faced in the implementation of the NOURISH-T+ trial so far (December 2019–March 2022) and describes adaptations made as a result of these disruptions in the areas of recruitment, data collection, and overall engagement. This reflection is based on a multisite cluster-RCT that aims to examine whether an intervention targeting parents as agents of change to promote healthy eating and physical activity in pediatric cancer survivors, NOURISH-T+ (Nourishing Our Understanding of Role modeling to Improve Support and Health for Healthy Transitions), reduces body mass and improves health behaviors compared to Brief NOURISH-T (Enhanced Usual Care/EUC). The COVID-19 pandemic has created and exacerbated challenges for our trial related to participant recruitment and engagement, technology access and literacy, and data collection and management, as well as COVID-related challenges (e.g. Zoom fatigue). Strategies used to address these challenges might prove helpful in future virtual or hybrid RCTs, including developing trust and rapport with participants, providing support through multiple routes of dissemination, and using data management applications (e.g. REDCap™) for automation and project management. Extra efforts to build families' trust and rapport, offering multiple routes of support, and automating as many tasks as possible are critical to ensuring the continuation of high-quality clinical trials during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]